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Yuhasz v. Wellcare Health Plans of New Jersey, Inc.

United States District Court, D. New Jersey

September 5, 2019

JOANNE N. YUHASZ, Plaintiff,
v.
WELLCARE HEALTH PLANS OF NEW JERSEY, INC., et al., Defendants.

          OPINION

          JOHN MICHAEL VAZQUEZ, U.S.D.J.

         Presently before the Court are motions to dismiss the Amended Complaint filed by the following: (1) Defendant WellCare Health Plans of New Jersey, Inc. ("WellCare"), D.E. 12; (2) Defendants Prime Rehabilitation ("Prime Rehabilitation") and Dana Boyle, D.E. 13; and (3) Defendants Tatyana Marx, M.D., and Neurology Specialists of Morris County, LLC ("Neurology Specialists"), D.E. 28.[1] Plaintiff Joanne N. Yuhasz did not oppose any of Defendants' motions.[2]For the reasons that follow, Defendants' motions are GRANTED.

         I. FACTUAL AND PROCEDURAL BACKGROUND

         Plaintiff Joanne N. Yuhasz brings this suit on behalf of herself and her mother, Diana S. Yuhasz. Plaintiff alleges that she has "full legal Power of Attorney and Medical Authorization" on behalf of her mother, whose alleged injuries are the primary subject of this matter. Am. Compl. ¶ 17, D.E. 1-1. Plaintiffs mother is a 95-year-old woman who, from in or around September 2015 until at least November 2016, resided at Regency Grande Post-Acute Nursing & Rehabilitation Center. Id. ¶¶ 22, 100. Plaintiff alleges that Defendant WellCare refused to provide "medically-necessary 'skilled care'" therapy. Id., ¶ 21. Moreover, at various times, Plaintiffs mother was denied treatment because she "did not possess the cognitive ability to receive physical therapy." Id. ¶ 83. When her mother did receive such treatment, Plaintiff further alleges, the therapies were wrongfully terminated on the basis of her mother's potential for improvement rather than her need for the skilled care therapies. Id. ¶ 102. As a result of Defendants' conduct, Plaintiff alleges that her mother suffered serious bodily injuries including impairment of her physical and mental faculties. Id., ¶ 123. Plaintiff further alleges two distinct injuries to herself: (1) expenses she incurred because of the denial of care and benefits to her mother, and (2) intentional infliction of emotional distress. Id. ¶¶ 79, 81, 131-32, 152-55.

         Plaintiff filed the Amended Complaint in state court on October 17, 2018, asserting eleven claims against Defendants including theories of breach of contract, intentional infliction of emotional distress, tortious interference with medical treatment, and others. In the Amended Complaint, Plaintiff seeks monetary compensation for the "skilled care" denied her mother, compensatory and punitive damages, special damages, interest, and attorney's fees. On December 12, 2018, Defendant Centers for Medicare & Medicaid Services ("CMS") removed the matter to this Court pursuant to 28 U.S.C. § 1442(a)(1). D.E. 1. On January 30, 2019, this Court filed a stipulation between the parties that dismissed all claims asserted against CMS. D.E. 11. Consequently, CMS is no longer a defendant in this matter. The remaining Defendants subsequently filed the instant motions to dismiss. D.E. 12, 13, 28.

         II. LEGAL STANDARD

         In all of the pending motions to dismiss, Defendants argue, among other things, that the Amended Complaint should be dismiss due to a lack of subject matter jurisdiction under Fed.R.Civ.P. 12(b)(1)[3] and because Plaintiff fails to state a claim pursuant to Fed.R.Civ.P. 12(b)(6).

         A. Rule 12(b)(1)

         To decide a Rule 12(b)(1) motion, a court must first determine whether the party presents a facial or factual attack against a complaint. A facial attack contests "subject matter jurisdiction without disputing the facts alleged in the complaint, and it requires the court to 'consider the allegations of the complaint as true.'" Davis v. Wells Fargo, 824 F.3d 333, 346 (3d Cir. 2016) (quoting Petruska v. Gannon Univ., 462 F.3d 294, 302 n.3 (3d Cir. 2006)). A factual attack challenges "the factual allegations underlying the complaint's assertion of jurisdiction, either through the filing of an answer or 'otherwise presenting competing facts.'" Davis, 824 F.3d at 346 (quoting Constitution Party of Pa. v. Aichele, 757 F.3d 347, 358 (3d Cir. 2014)). Here, in seeking dismissal for lack of subject matter jurisdiction, the parties rely solely on Plaintiffs allegations in the Amended Complaint. Accordingly, Defendants present a facial attack. As a result, like a Rule 12(b)(6) motion to dismiss, "the Court must consider the allegations of the complaint as true." Mortensen v. First Fed. Sav. & Loan Ass 'n, 549 F.2d 884, 891 (3d Cir. 1977).

         B. Rule 12(b)(6)

         Rule 12(b)(6) permits a court to dismiss a complaint that fails "to state a claim upon which relief can be granted[.]" For a complaint to survive dismissal under Rule 12(b)(6), it must contain sufficient factual matter to state a claim that is plausible on its face. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). A claim is facially plausible "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. Further, a plaintiff must "allege sufficient facts to raise a reasonable expectation that discovery will uncover proof of her claims." Connelly v. Lane Const. Corp., 809 F.3d 780, 789 (3d Cir. 2016). In evaluating the sufficiency of a complaint, district courts must separate the factual and legal elements. Fowler v. UPMC Shadyside, 578 F.3d 203, 210-211 (3d Cir. 2009). Restatements of the elements of a claim are legal conclusions, and therefore, are not entitled to a presumption of truth. Burtch v. Milberg Factors, Inc., 662 F.3d 212, 224 (3d Cir. 2011). The Court, however, "must accept all of the complaint's well-pleaded facts as true." Fowler, 578 F.3d at 210. Even if plausibly pled, however, a complaint will not withstand a motion to dismiss if the facts alleged do not state "a legally cognizable cause of action." Turner v. J.P. Morgan Chase & Co., No. 14-7148, 2015 WL 12826480, at *2 (D.N.J. Jan. 23, 2015).

         In addition, the Court notes that Plaintiff here is proceeding pro se. Courts have an obligation to liberally interpret a pro se litigant's pleadings. Higgs v. Att'y Gen., 655 F.3d 333, 339 (3d Cir. 2011). Courts should thus apply the relevant legal principle even when the complaint has failed to name it. Dluhos v. Strasberg, 321 F.3d 365, 369 (3d Cir. 2003). Nevertheless, pro se litigants must still allege sufficient facts to support their claims. Mala v. Crown Bay Marina, Inc., 704 F.3d 239, 245 (3d Cir. 2013).

         III. ANALYSIS

         A. ...


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